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脊柱后凸增加预示着老年社区居住女性的活动能力恶化:一项前瞻性队列研究。

Increasing kyphosis predicts worsening mobility in older community-dwelling women: a prospective cohort study.

机构信息

Department of Physical Therapy and Rehabilitation Science, University of California at Los Angeles, Los Angeles, California, USA.

出版信息

J Am Geriatr Soc. 2011 Jan;59(1):96-100. doi: 10.1111/j.1532-5415.2010.03214.x. Epub 2011 Jan 3.

Abstract

OBJECTIVES

To determine whether increasing kyphosis angle was independently associated with poorer mobility as measured according to the Timed Up and Go Test (TUG), after controlling for other established risk factors.

DESIGN

Prospective cohort study.

SETTING

Eleven clinical centers in the United States.

PARTICIPANTS

Two thousand seven hundred seventy-seven women aged 55 to 80 randomized to the placebo arms of the Fracture Intervention Trial, a randomized controlled trial of the effect of alendronate on risk for osteoporotic fractures.

MEASUREMENTS

The primary predictor was change in kyphosis angle, measured using the Debrunner Kyphometer; the outcome was change in mobility, measured as performance time on the TUG. Covariates were baseline age, kyphosis angle, body mass index (BMI), self-reported health status, grip strength, change in total hip bond mineral density (BMD), and number of vertebral fractures over a mean of 4.4 years.

RESULTS

Greater kyphosis angle predicted longer mobility performance times (P<.001), independent of other significant predictors of worsening mobility including age, baseline kyphosis, health status, grip strength, BMI, change in hip BMD, and new vertebral fractures. TUG performance times increased by 0.02 seconds (95% confidence interval (CI)=0.01-0.03) for every 5° increase in kyphosis angle, more than the increase in mobility time of 0.01 seconds (95% CI=0.005-0.03) over 1 year observed in this cohort.

CONCLUSION

Increasing kyphosis angle is independently associated with worsening mobility. Interventions are needed to prevent or reduce increasing kyphosis and mobility decline.

摘要

目的

在控制其他已确定的危险因素后,确定后凸角度的增加是否与根据计时起立行走测试(TUG)测量的较差移动能力独立相关。

设计

前瞻性队列研究。

地点

美国的 11 个临床中心。

参与者

2777 名年龄在 55 至 80 岁之间的女性,她们被随机分配到阿伦膦酸盐对骨质疏松性骨折风险影响的骨折干预试验的安慰剂组。

测量

主要预测指标是使用 Debrunner 脊柱侧凸计测量的后凸角度变化;结果是移动能力的变化,用 TUG 的表现时间来衡量。协变量为基线年龄、后凸角度、体重指数(BMI)、自我报告的健康状况、握力、总髋部骨密度(BMD)变化以及 4.4 年期间新的椎体骨折数量。

结果

更大的后凸角度预示着移动能力表现时间的延长(P<.001),独立于其他移动能力恶化的重要预测因素,包括年龄、基线后凸、健康状况、握力、BMI、髋部 BMD 变化和新的椎体骨折。后凸角度每增加 5°,TUG 表现时间就会增加 0.02 秒(95%置信区间(CI)=0.01-0.03),而在该队列中,1 年内移动时间的增加仅为 0.01 秒(95%CI=0.005-0.03)。

结论

后凸角度的增加与移动能力的恶化独立相关。需要采取干预措施来预防或减少后凸角度的增加和移动能力的下降。

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